摘要
目的探讨右美托咪定对西宁地区高原红细胞增多症手术患者围手术期血栓弹力图变化的影响。方法选择我院2016年3月～2017年6月收治的106例西宁地区高原红细胞增多症手术患者作为研究对象,随机分为对照组和观察组,各53例,两组患者均给予气管内插管全身麻醉,其中观察组患者在麻醉诱导前10 min给予右美托咪定,对照组给予等量的生理盐水,比较两组患者手术前后的动脉血氧合、应激反应以及血栓弹力图指标差异。结果术前两组患者的动脉血氧合指标、应激指标以及血栓弹力图参数差异无统计学意义(P>0.05)。与术前相比,观察组患者术后动脉血氧合指标无明显变化,对照组术后血氧分压(partial pressure of oxygen,PaO_2)、血氧饱和度(Blood oxygen saturation,SaO_2)值明显升高(P<0.05),而平均动脉压(Mean arterial pressure,MAP)、心率(Heart rate,HR)无明显变化;观察组患者术后应激指标无明显变化,对照组明显升高;对照组患者术后的凝血反应时间(Coagulation reaction time,R)和凝血时间(Clotting time,K)值明显降低(P<0.05),α、最大振幅(Maximum amplitude,MA)、凝血综合指数(coagulation index,CI)和纤溶指数(fibrinolysis index,LY30)值明显升高,观察组无明显变化。结论右美托咪定用于西宁地区高红症手术患者可以增强围术期应激耐受性,改善围术期凝血以及纤溶功能。
Objective To investigate the effect of dexmedetomidine on perioperative thromboelastography in patients with altitude polycythemia during Xining district. Methods A total of 106 patients with high altitude polycythemia in Xining from March 2016 to June 2017 were selected as study subjects and randomly divided into control group and observation group, with 53 cases in each group, both groups were given endotracheal intubation general anesthesia, the observation group patients were given dexmedetomidine 10 min before the induction of anesthesia, the control group was given the same amount of saline, differences in arterial oxygenation, stress response and thromboelastometry before and after surgery were compared between the two groups. Results There was no significant difference in arterial oxygenation index, stress index and thromboelastography parameters between the two groups before surgery(P>0.05). Compared with that before operation, there was no significant change of arterial oxygenation index after operation in the observation group. The PaO2 and SaO2 values in the control group were significantly increased(P<0.05), but the MAP and HR had no significant change. There was no significant change in the postoperative stress index in the observation group, but the control group was significantly higher. Compared with preoperative, the R and K values of the control group were significantly lower(P<0.05), while the values of α, MA, CI and LY30 were significantly higher, There were no significant changes in the indicators of the observation group. Conclusion Dexmedetomidine for patients with hyperviscosity in Xining can enhance perioperative stress tolerance and improve perioperative coagulation and fibrinolysis.
作者
索才让杰
郑峰
SUO Cairangjie;ZHENG Feng(Department of Anesthesiology, the People's Hospital of Qinghai Province, Xining 810000, China;Department of Orthopaedics, the People's Hospital of Qinghai Province, Xining 810000, China)
出处
《中国现代医生》
2019年第8期131-135,共5页
China Modern Doctor
基金
青海省卫计委医药卫生科研指导性计划课题(2016-wjzdx-06)
关键词
右美托咪定
高红症
应激反应
血栓弹力图
Dexmedetomidine
Hyperviscosity
Stress response
Thrombelastography
